Background We have previously shown that, in women treated for 3 years with strontium ranelate, an increase in hip bone mineral density (BMD), but not spine BMD, was associated with a proportional reduction in vertebral fracture incidence (Bruyere et al, Journal of Clinical Endocrinology and Metabolism, 2007). As a matter of fact, each 1% in femoral neck or total proximal femur BMD was associated with decreased risk to experience a new vertebral fracture by 3% (95% adjusted CI 1%>5%) and 2% (1%>4%), respectively. Some women have now been treated for 10 years with strontium ranelate.
Objectives Our objective is to assess the relationship between change in BMD and vertebral fracture incidence in the last 2 years of the 10-year treatment.
Methods We have included women from the strontium ranelate arm of the Spinal Osteoporosis Therapeutic Intervention study (SOTI) and the TReatment Of Peripheral OSteoporosis study (TROPOS) having received the treatment for 10 years.
Results 116 women with femoral neck and total hip BMD and fracture data available during the 10 years of follow-up were included in the present analysis. During the last two years of follow-up, 12 patients experienced a new vertebral fracture. After having controlled for age, body mass index at year 9, BMD at year 9, number of vertebral fracture at year 0, number of new vertebral fracture from year 0 to year 8, we found that the BMD change at the femoral neck from years 9 to 10 was significantly associated with vertebral fractures incidence during the same period of time (p=0.03). Each 1% increase in femoral neck BMD was associated with a 15% (95% adjusted CI 2% to 26%) decreased risk to experience a new vertebral fracture. The same trend was observed for total hip BMD (7% [95%CI -3% to 17%) but it did not reach statistical significance (p=0.16). Women with new vertebral fractures from years 9 to 10 experienced during the same period a decrease of 2.4 (4.7) % in femoral neck BMD, compared to an increase of 1.5 (8.3) % in women without new vertebral fracture.
Conclusions During the last 2 years of a 10-year treatment with strontium ranelate, the increase in femoral neck BMD was associated with a proportional reduction of the incidence of new vertebral fractures. These results confirm that the assessment of femoral neck BMD could be of interest to monitor women treated with strontium ranelate.
Disclosure of Interest None Declared
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